Journal of Addiction Medicine最新文献_第8页

Oral Health Risks of Transmucosal Buprenorphine: Commentary on Tuan et al. and Zheng et al. 经黏膜丁丙诺啡的口腔健康风险：评Tuan等，Zheng等。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-11 DOI: 10.1097/ADM.0000000000001452

Anne C Black, William C Becker

{"title":"Oral Health Risks of Transmucosal Buprenorphine: Commentary on Tuan et al. and Zheng et al.","authors":"Anne C Black, William C Becker","doi":"10.1097/ADM.0000000000001452","DOIUrl":"10.1097/ADM.0000000000001452","url":null,"abstract":"Opioid use disorder affects millions of people nationally and in 2022 opioid overdose deaths exceeded 80,000. Buprenorphine, a partial mu-opioid receptor agonist, is a gold standard treatment for opioid use disorder, improving withdrawal symptoms and decreasing opioid-related mortality. However, a 2022 Food and Drug Administration warning about oral health problems related to transmucosal formulations has precipitated new research into this medication's potential risks. Two timely studies included in this issue of Journal of Addiction Medicine provide important new insight into potential causal effects and mechanisms of transmucosal buprenorphine's impact on oral disease. Using propensity score-weighted survival analysis, Tuan and colleagues demonstrated significantly greater risk for oral health problems in patients with opioid use disorder exposed to transmucosal buprenorphine compared to those not exposed. Taking a vastly different approach, Zheng and colleagues explored mechanisms of oral health risk by exposing rats to transmucosal or intravenous buprenorphine. Results described prolonged oral fluid buprenorphine exposure, a condition proposed to increase risk for tooth decay, was associated with greater accumulated buprenorphine in the salivary gland associated with sublingual buprenorphine administration. These novel studies advance our understanding of the plausibility of a causal relationship between transmucosal buprenorphine and oral health problems and suggest the importance of prescriber-patient discussions about risk mitigating oral hygiene practices and close monitoring of oral disease development. Additional research is needed into the relative oral health risks of full-opioid agonist versus transmucosal buprenorphine exposure and current barriers to long-acting injectable buprenorphine.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12210154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk of Cannabis Use Disorder in Chronic Pain: Longitudinal Links to Pain Outcomes. 慢性疼痛中大麻使用障碍的风险：与疼痛结果的纵向联系。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-11 DOI: 10.1097/ADM.0000000000001446

Chung Jung Mun, Patricia Timmons, Iosef I Perez, Madeline H Meier, Stephen T Wegener, Claudia M Campbell, Rachel V Aaron

{"title":"Risk of Cannabis Use Disorder in Chronic Pain: Longitudinal Links to Pain Outcomes.","authors":"Chung Jung Mun, Patricia Timmons, Iosef I Perez, Madeline H Meier, Stephen T Wegener, Claudia M Campbell, Rachel V Aaron","doi":"10.1097/ADM.0000000000001446","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001446","url":null,"abstract":"Objectives: The aim of this study was to compare individuals with chronic pain who were cannabis nonusers and those at low, moderate, and high cannabis use disorder (CUD) risk levels on baseline psychosocial and pain-related characteristics, as well as the longitudinal trajectories of pain severity and interference.Methods: A cohort of 1453 individuals with chronic pain, recruited online, participated in this 2-year longitudinal study, which included baseline, 3-, 12-, and 24-month follow-up surveys. The Cannabis Abuse Screening Test was used to assess CUD risk, and the Brief Pain Inventory was used to assess pain outcomes.Results: Among participants (65.5% female; 86.1% White), 36.3% reported using cannabis, and 39.8% of cannabis users showed high CUD risk. Compared with nonusers, individuals at higher CUD risk tended to be younger, male, of lower socioeconomic status, and at higher risk of alcohol use disorder. They also reported greater pain severity and interference, more pronounced central sensitization symptoms, and elevated mental health symptoms. However, pain severity and interference trajectory slopes over 2 years were not different among the nonusers versus individuals at varying CUD risk levels.Conclusions: A significant portion of individuals with chronic pain who use cannabis may be at risk for CUD. Although higher CUD risk was not associated with worsening pain outcomes over 2 years compared to nonusers, its connection to worse mental health and pain symptoms at baseline highlights the need for targeted CUD risk assessments, patient education on CUD risk, and integrated care with mental health support in chronic pain management.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Relationship Between Methadone Induction Dosing and Retention in Treatment in Opioid Treatment Programs. 阿片类药物治疗方案中美沙酮诱导剂量与保留的关系。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-10 DOI: 10.1097/ADM.0000000000001473

Robert C Sherrick

{"title":"Relationship Between Methadone Induction Dosing and Retention in Treatment in Opioid Treatment Programs.","authors":"Robert C Sherrick","doi":"10.1097/ADM.0000000000001473","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001473","url":null,"abstract":"Objectives: Methadone medication for opioid use disorder is effective in reducing opioid use and associated risks, but early dropout from treatment remains a challenge. Current guidelines recommend conservative methadone dose titration, yet slower dose escalation may lead to continued withdrawal symptoms, opioid use, or premature treatment discontinuation. This study investigates the relationship between the first week of methadone dosing and 30-day treatment retention.Methods: This retrospective cohort study included 14,489 patients newly admitted to a network of 64 OTPs between 2020 and 2023. Patients who received an initial methadone dose >30 mg or missed any dosing during the first week were excluded. The primary outcome was 30-day retention. Logistic regression was used to examine the association between methadone dose at day 7-day and 30-day retention.Results: Higher methadone doses on day 7 were significantly associated with improved 30-day retention (P < 0.0001). Patients receiving 70 mg or more on day 7 had a retention rate of 91.24%, compared with 79.51% for those receiving <30 mg. A clear dose-response relationship was observed, with retention rates increasing as the day 7 dose increased.Conclusions: More rapid methadone induction, particularly higher doses by day 7, is associated with improved 30-day retention. Current conservative induction guidelines may need to be revised to allow for more rapid dose escalation while balancing improved treatment outcomes with safety. Further research is necessary to assess the impact of methadone induction dosing on mortality and adverse events.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Risk of Oral Health Problems in Adults with Opioid Use Disorder Treated with Transmucosal Buprenorphine. 经黏膜丁丙诺啡治疗阿片类药物使用障碍的成人口腔健康问题的风险

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-10 DOI: 10.1097/ADM.0000000000001453

Wen-Jan Tuan, Karl T Clebak, Elhaam Jawadi, Jessica Snyder, Aleksandra E Zgierska

{"title":"Risk of Oral Health Problems in Adults with Opioid Use Disorder Treated with Transmucosal Buprenorphine.","authors":"Wen-Jan Tuan, Karl T Clebak, Elhaam Jawadi, Jessica Snyder, Aleksandra E Zgierska","doi":"10.1097/ADM.0000000000001453","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001453","url":null,"abstract":"Objectives: In early 2022, based on limited case-report evidence, the US Food and Drug Administration warned about possible oral health problems associated with transmucosal (sublingual, buccal) buprenorphine formulations commonly used to treat opioid use disorder (OUD). The purpose of this study was to assess the risk of adverse oral health outcomes among adults prescribed transmucosal buprenorphine for OUD.Methods: This retrospective cohort study utilizing TriNetX claims data consisted of adults diagnosed with OUD in 2002-2019, and who either filled ≥3 transmucosal buprenorphine prescriptions within any 6-month period (buprenorphine cohort) or did not fill any buprenorphine prescriptions (control cohort). Weighted propensity score matching and Cox proportional hazards regression were applied to evaluate the probability of new oral health problem diagnoses during the follow-up period, which lasted up to 5 years after the index date (ie, first buprenorphine prescription or first diagnosis of OUD date, respectively), with outcomes at 1 and 5 years serving as the main risk measures.Results: The study included 721,878 adults with OUD, with 156,594 (21.7%) in the buprenorphine cohort. Persons prescribed buprenorphine displayed a 1.24-1.30 higher adjusted risk of acquiring new oral health problem diagnoses both at 1- and 5-year follow-up (P < 0.001).Conclusions: Our claims data-based results suggest associations between transmucosal buprenorphine use and developing oral health problems among adults with OUD, underscoring the importance of targeted prospective research as well as counseling patients about this potential risk and ways to mitigate it, without unnecessarily deterring patients from this evidence-based treatment.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Challenges of Drug Testing in Addiction Treatment: A Case Report of Protracted Fentanyl Clearance in a Patient Involved With Child Protective Services and Probation. 药物测试在成瘾治疗中的挑战：一个涉及儿童保护服务和缓刑的芬太尼清除患者的病例报告。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-07 DOI: 10.1097/ADM.0000000000001477

Muhammet Celik, Eliza Zimmerer, Brittany Maxwell, Christopher Aloezos

{"title":"Challenges of Drug Testing in Addiction Treatment: A Case Report of Protracted Fentanyl Clearance in a Patient Involved With Child Protective Services and Probation.","authors":"Muhammet Celik, Eliza Zimmerer, Brittany Maxwell, Christopher Aloezos","doi":"10.1097/ADM.0000000000001477","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001477","url":null,"abstract":"Fentanyl, a potent synthetic opioid, has been linked to an increasing number of overdose deaths in the United States. It began replacing heroin in the illicit drug supply in 2013, and now contributes to both drug-related criminal offenses and the need for treatment. Its unique pharmacokinetics complicate the role of drug testing, which is a ubiquitous practice in both criminal justice and treatment settings. Still, there exists no clear consensus on the role of drug testing in clinical practice for patients involved in the criminal justice system. In this case report, we describe an adult female patient in outpatient addiction treatment for opioid use disorder who self-reported fentanyl abstinence while receiving medication for addiction treatment. The patient's drug test results remained positive for fentanyl and its metabolite, norfentanyl, for 95 days and 245 days. This case illustrates the challenges of relying on drug testing in the treatment of substance use disorders due to the lack of definitive interpretation guidelines for drug levels. In addition, it highlights the importance of advocacy and collaboration between treatment providers and third-party legal entities. It may provide guidance on the role of urine drug testing in substance use treatment, particularly for emerging substances with largely unknown metabolic properties.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Navigating Choices: Pregnancy Options Counseling Experiences in Individuals With Opioid Use Disorder. 导航选择：阿片类药物使用障碍个体的妊娠选择咨询经验。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-07 DOI: 10.1097/ADM.0000000000001476

Blythe Bynum, Katherine M Mahoney, Tachianna Griffiths, Arden McAllister, Courtney Schreiber, Sarita Sonalkar, Nia Bhadra-Heintz

{"title":"Navigating Choices: Pregnancy Options Counseling Experiences in Individuals With Opioid Use Disorder.","authors":"Blythe Bynum, Katherine M Mahoney, Tachianna Griffiths, Arden McAllister, Courtney Schreiber, Sarita Sonalkar, Nia Bhadra-Heintz","doi":"10.1097/ADM.0000000000001476","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001476","url":null,"abstract":"Objectives: People with childbearing potential and opioid use disorder (OUD) have high rates of unintended pregnancies. Addiction medicine providers occupy an important role in diagnosing and counseling those who become pregnant; however, no guidelines exist to facilitate these conversations. We sought to explore participant experiences with pregnancy options counseling while in opioid use disorder treatment clinics.Methods: We conducted semistructured interviews with people who became pregnant while in OUD treatment, regardless of pregnancy outcome. The interview domains included (1) interactions with health care upon pregnancy discovery, (2) pregnancy options counseling provision, and (3) factors affecting pregnancy decision. A codebook was formulated through an iterative process using a P3 framework (practice, provider, patient). All interviews were double-coded and analyzed for content and themes.Results: Eighteen participants completed interviews between December 2022 and April 2023. Participants reported valuing nonjudgmental communication when providers disclose unexpected pregnancy results, as well as the need for unbiased and trustworthy information regarding the impact of OUD and OUD treatment on their options. They also identified the unique stigma and bias experienced by pregnant people with OUD.Conclusions: Although no guidelines exist to guide pregnancy options counseling in addiction medicine settings, efforts should be made to integrate all pregnancy options counseling-parenting, adoption, and abortion-and/or referrals into the care of pregnant patients at OUD treatment centers. Effective discussions should be conducted in a nonbiased and nonjudgmental fashion. Our findings can be used to develop patient-centered counseling aimed at improving pregnancy decision-making while in treatment for OUD.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Call for Better Guidance and Treatments for Comorbid Postpartum Depression and Substance Use Disorders. 呼吁更好的指导和治疗产后抑郁症和物质使用障碍。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-05 DOI: 10.1097/ADM.0000000000001475

Jeffrey Pan, Kevin Y Xu, Evan Wood

引用次数: 0

The Impact of Frequency of Cannabis Use on Hypertensive Disorders During Pregnancy. 妊娠期大麻使用频率对高血压疾病的影响。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-03 DOI: 10.1097/ADM.0000000000001454

Nichole Nidey, Erica Raff, Md Tareq Ferdous Khan, Shannon Lea Watkins, Jennifer M Jm McAllister, Laura Kair, Mishka Terplan, Andrea Greiner

{"title":"The Impact of Frequency of Cannabis Use on Hypertensive Disorders During Pregnancy.","authors":"Nichole Nidey, Erica Raff, Md Tareq Ferdous Khan, Shannon Lea Watkins, Jennifer M Jm McAllister, Laura Kair, Mishka Terplan, Andrea Greiner","doi":"10.1097/ADM.0000000000001454","DOIUrl":"10.1097/ADM.0000000000001454","url":null,"abstract":"Objectives: Cannabis is 1 of the most commonly used substances during pregnancy, and there is mixed evidence of its impact on maternal outcomes, such as hypertensive disorders. Prior research on cannabis use during pregnancy has not accounted for use frequency, which might explain mixed results across studies. The objective of this study was to examine how frequencies of use during pregnancy are associated with hypertensive disorders.Methods: This was a retrospective cohort study of the 2017-2018 Pregnancy Risk Assessment Monitoring System survey (n = 10,911/weighted n = 587,486). Frequency of cannabis use was categorized for analysis as follows: no use, minimal use (1 time per month or less), moderate use (2 times per month to 1 day per week), and frequent use (2-6 times per week to daily). Multivariable logistic regression models were used to examine how the frequency of cannabis use influenced the odds of experiencing hypertensive disorders during pregnancy.Results: Cannabis use, measured as a binary exposure variable (yes/no), was not associated with higher odds of hypertension during pregnancy (odds ratio, 0.86; 95% confidence interval, 0.54, 1.35). However, among those with any cannabis use, frequent use (vs minimal use) was associated with higher odds of hypertensive disorders (odds ratio, 3.44; confidence interval, 1.40, 8.43).Conclusions: Identifying cannabis use frequency during pregnancy can help identify maternal risk of hypertensive disorders.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Confusing Terminology of "Medical Cannabis" and Cannabinoid Products. “医用大麻”和大麻素产品的混淆术语。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-03 DOI: 10.1097/ADM.0000000000001471

Jennifer A Ross, William Riccardelli, Sharon Levy

引用次数: 0

Stigmatizing Language in Substance Use-related International Classification of Diseases Codes. 与物质使用有关的国际疾病分类代码中的污名化语言。

IF 4.2 3区医学

Journal of Addiction Medicine Pub Date : 2025-03-03 DOI: 10.1097/ADM.0000000000001462

Neeraj Chhabra, Huiyi Hu, Rebecca T Feinstein, Niranjan S Karnik

{"title":"Stigmatizing Language in Substance Use-related International Classification of Diseases Codes.","authors":"Neeraj Chhabra, Huiyi Hu, Rebecca T Feinstein, Niranjan S Karnik","doi":"10.1097/ADM.0000000000001462","DOIUrl":"https://doi.org/10.1097/ADM.0000000000001462","url":null,"abstract":"Objectives: Healthcare-associated stigma is a critical barrier for treatment engagement for patients with substance use disorders. Although there are efforts to combat stigmatizing language in clinical documentation, little is known about the presence of substance use-related stigmatizing language in structured diagnosis codes ubiquitous in clinical medicine.Methods: We examined the presence of substance use-related stigmatizing terms contained within the International Classification of Diseases, 10th revision, clinical modification (ICD-10-CM) diagnosis code descriptions. Stigmatizing terms were compiled from guidelines authored by the National Institute on Drug Abuse, while ICD-10-CM codes were obtained from the United States Centers for Disease Control and Prevention.Results: We evaluated 74,259 ICD-10-CM code descriptions and identified 173 substance use-related codes with stigmatizing language. The stigmatizing terms detected were \"abuse\" (157 code descriptions), \"alcoholic\" (16), and \"drug abuser\" (2). The term \"abuse\" was used in relation to multiple substances including alcohol, opioids, cannabis, sedatives, hypnotics and anxiolytics, cocaine, stimulants, hallucinogens, inhalants, other psychoactive substances, tobacco, and other medicinal products.Conclusions: Stigmatizing language is used in multiple ICD-10-CM code descriptions. Subsequent iterations should bring ICD-10-CM code descriptions in line with current recommendations for destigmatized descriptors to avoid the perpetuation of stigma in healthcare.","PeriodicalId":14744,"journal":{"name":"Journal of Addiction Medicine","volume":" ","pages":""},"PeriodicalIF":4.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0